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An infection in a central venous access device is not eliminated by giving antibiotics through the catheter. How might bacterial glycocalyx contribute to this?
- A. It protects the bacteria from antibiotic and immunologic destruction.
- B. Glycocalyx neutralizes the antibiotic, rendering it ineffective.
- C. It competes with the antibiotic for binding sites on the microbe.
- D. Glycocalyx provides nutrients for microbial growth.
Correct Answer: A
Rationale: Glycocalyx is a viscous polysaccharide or polypeptide slime that covers microbes, enhancing adherence to surfaces, resisting phagocytic engulfment, and preventing antibiotics from contacting the microbe.
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The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
- A. platelet count
- B. protime (PT)
- C. partial thromboplastin time (PTT)
- D. D-dimer
Correct Answer: D
Rationale: The D-dimer test specifically detects fibrin degradation products, indicating DIC's characteristic clotting and fibrinolysis. Other tests are less specific.
The client is experiencing delirium from substance withdrawal. Which medication, if prescribed prn, should the nurse administer to help calm the client?
- A. Flumazenil_1.PNG
- B. Flumazenil_2.PNG
- C. Flumazenil_3.PNG
- D. Flumazenil_4.PNG
Correct Answer: D
Rationale: Lorazepam (Ativan) depresses the CNS, reducing anxiety and calming the client during withdrawal.
Which of the following of Erikson's developmental stages are relevant to adults ages 18-64? Select all that apply.
- A. Ego Integrity vs. Despair
- B. Generativity vs. Stagnation
- C. Industry vs. Inferiority
- D. Initiative vs. Guilt
- E. Intimacy vs. Isolation
Correct Answer: A
Rationale: In the adult 18-64 stage, Intimacy vs. Isolation is relevant to young adulthood and Generativity vs. Stagnation is relevant to middle adulthood. Initiative vs. Guilt is relevant to preschool childhood. Industry vs. Inferiority is relevant to school-age childhood. Ego Integrity vs. Despair is relevant to mature adulthood after age 65.
The LPN is caring for a client admitted for acute pancreatitis. Which of these medications would be least appropriate for pain management?
- A. Tylenol
- B. Tramadol
- C. Codeine
- D. Morphine
Correct Answer: D
Rationale: Morphine is contraindicated for pain management in pancreatitis because it causes spasms in the Sphincter of Oddi.
The 11-year-old with type 1 DM is learning to use insulin pens for basal-bolus insulin therapy with both a very-long-acting insulin and rapid-acting insulin. Which action by the child should indicate to the nurse that additional teaching is needed?
- A. The child holds the insulin glargine pen against the skin for 10 seconds after administering the correct amount of insulin.
- B. The child counts the number of carbohydrates eaten at breakfast and selects the insulin lispro pen for covering the carbohydrates eaten.
- C. The child counts the number of carbohydrates eaten at lunch and selects the insulin glargine pen for covering the carbohydrates eaten.
- D. The child determines that the blood glucose level at bedtime is within the normal range, eats a piece of turkey, and tells the nurse that coverage is not needed with insulin lispro.
Correct Answer: C
Rationale: A: To ensure that the medication is administered with the insulin pens, the pen is held in place for 10 seconds after delivery of the medication. This action is correct. B: Insulin lispro (Humalog) is rapid-acting insulin with an onset of 5 to 10 minutes. This action is correct. C: Insulin glargine (Lantus) is very-long-acting insulin administered once daily and is not used for covering the number of carbohydrates eaten. This action indicates the child needs additional teaching. D: The rapid-acting insulin lispro (Humalog) is not needed if the glucose level is WNL. Turkey does not contain carbohydrates; insulin is administered to cover only the carbohydrates eaten. This action is correct.